Perfil alimentar e nutricional de lactentes atendidos em unidade básica de saúde no Rio Grande do Norte

Objectives: Check the profile of breastfeeding, introduction of foods, eating habits, nutritional status of infants and relate the duration of exclusive breastfeeding (EBF) and maternal anemia. Methods: Cross-sectional study of 22 infants 6-24 months old. Mothers answered a semistructured questionnaire and the infant underwent anthropometric assessment. Statistical analysis was performed using the chi-squared test, considering a significance level p < 0.05.Results: 22.73% were overweight, the average Exclusive Breastfeeding was 123.2 days (SD ± 68.9 days), 63.63% for less than 6 months. The duration of exclusive breastfeeding was significantly associated with female sex (p= 0.042) and the number of prenatal visits (p = 0.002), 36.4% of mothers had anemia during pregnancy, this was associated with sanitation (p = 0.03) and the number of prenatal visits (p = 0.002). The foods most frequently introduced before six months were, respectively, fruit juice (27.3%), sugar (21%), fruit (13.63%), rice or macaroni (9%), beef, chicken or egg (5.3%), vegetables (5%) and beans (4.8%). Conclusion: EBF is little practiced, the increase in the early introduction of other foods being a cause for concern, it being essential to create strategies to encourage and support breastfeeding, as well as preventoverweight in this age group.Objetivos: Verificar o perfil de aleitamento materno, introdução de alimentos, hábitos alimentares, estado nutricional de lactentes e relacionar o tempo de aleitamento materno exclusivo (AME) e anemia materna. Método: Estudo transversal com 22 lactentes de 6 a 24 meses. As mães responderam a um questionário semiestruturado e o lactente foi submetido à avaliação antropométrica. A análise estatística foi realizada por meio do teste Qui-quadrado, considerandose o nível de significância p < 0,05. Resultados: 22,73% apresentaram excesso de peso, o tempo médio de (AME) foi de 123,2 dias (DP ± 68,9 dias), 63,63% por tempo inferior a 6 meses. A duração do AME foi associada significativamente ao sexo feminino (p = 0,042) e ao número deconsultas de pré-natal (p = 0,002), 36,4% das mães apresentaram anemia na gestação, que foi associada ao saneamento básico (p = 0,03) e ao número de consultas de pré-natal (p = 0.002). Os alimentos mais frequentes introduzidos antes dos seis meses foram respectivamente, suco de frutas (27,3%), açúcar (21%), fruta (13,63%), arroz ou macarrão (9%), carne ou frango ou ovo (5,3%) verduras e legumes (5%) e feijão (4,8%). Conclusão: A prática do AME apresentase baixa, o crescente aumento da introdução precoce de alimentos mostra-se preocupante, sendo fundamental a criação de estratégias de incentivo e apoio a amamentação, assim como a prevenção de excesso de peso nessa faixa etária

Relação entre insuficiência/deficiência da vitamina d, inflamação e estresse oxidativo em adolescentes escolares com excesso de peso

INTRODUCTION: Adolescence comprises the age 10-19 years. This phase is marked biological and physiological changes, including highlighting the bone mineral growth, which is dependent on the nutritional status of calcium and vitamin D. In recent years, studies of adolescents showed high rates of failure / vitamin D deficiency in several countries. Vitamin D has an important role in bone growth and recent evidence has associated the vitamin D status with diabetes, hypertension, cancer and increased biomarkers of oxidative stress and inflammation in adults and the elderly. In adolescents, studies have shown an association between low serum concentrations of vitamin D and the increase in cardiometabolic risk factors. OBJECTIVE: The aim of this study was to evaluate the insufficiency/deficiency of vitamin D and its association with cardio metabolic risk factors in adolescents. METHODS: A Cross-sectional study including 209 adolescents aged 15 to 19 years old, recruited from public schools in the city of João Pessoa, Brazil. Personal data and sun exposure were collected through questionnaires. The dietary intake was assessed by applying a 24-hours recall. Nutritional status was assessed by body mass index (BMI), waist circumference (WC) and the waist-to-height ratio (WHtR) according to the cut-offs for age criteria. Blood pressure was measured according to the protocol of the Brazilian Society of Hypertension. It was collected blood samples to measure levels of 25-hidrovitmina D, Parathyroid hormone, glucose and lipid profile, C-reactive-protein (CPR), alpha-1-acid-glycoprotein(AGP-A), malondialdehyde (MDA), and total antioxidant capacity (TAC). The research was approved by the Research Ethics Committee of the CCS / UFPB under the Protocol 0139/15. Statistical analysis was performed using the "Statistical Pac age for Social Sciences" (SPSS Inc., Chicago, USA), version 21, adopting significance of p <0.05. RESULTS: The insufficiency/deficiency (≤ 30 ng/mL) of vitamin D was observed in 57, 4 % (CI 95% -50,6-64) of the adolescents, and in 76 % (CI 95%-62,8-86,3) of those were overweight. Dietary intake of vitamin D was inadequate ( 60 ± 18 μg) in 100% of the sample. Low levels of 25 (OH) D were associated with female gender (RP= 2, 3; CI 95% = 1, 8-3, 5; p=0), central adiposity measures by the WC (p = 0.02) and WHR (0.01), lower TAC (p = 0.01) and serum calcium (p = 0.00). The adolescents showed an inverse correlation between the total cholesterol (p = 0.01; r = -0.167) and BMI (p = 0.02; r = -0.166) with the levels of 25 (OH) D. The CPR values, the AGP-A, and MDA were increased in those that were both vitamin D deficient/insufficient and overweight (p = 0.00). CONCLUSION: The insufficiency/deficiency of vitamin D was associated with BMI, WC and WHtR, lower TAC and higher total cholesterol levels, suggesting that inadequate levels of vitamin D promotes the increased risk in the development of diseases associated with overweight, process inflammatory and oxidative stress.INTRODUÇÃO: A adolescência compreende a idade de 10 a 19 anos. Esta fase é marcada transformações biológicas e fisiológicas, entre elas destacando-se o crescimento mineral ósseo, o qual é dependente do estado nutricional de cálcio e vitamina D. Nos últimos anos, estudos realizados com adolescentes demonstram altas prevalências de insuficiência/deficiência de vitamina D em diversos países. A vitamina D possui papel essencial no crescimento ósseo e recentemente evidências tem associado o status de vitamina D com diabetes, hipertensão, câncer e aumento dos biomarcadores de estresse oxidativo e processo inflamatório na população adulta e idosa. Em adolescentes, estudos já demonstram uma associação entre as baixas concentrações séricas de vitamina D e o aumento dos fatores de riscos cardiometabólicos. OBJETIVO: Avaliar a insuficiência/deficiência da vitamina D e sua associação com fatores de riscos cardiometabólico em adolescentes. METODOLOGIA: Foi realizado estudo transversal com 209 adolescentes de idade entre 15 e 19 anos recrutados em escolas públicas na cidade de João Pessoa-PB, Brasil. Os dados pessoais e de exposição solar foram coletados por meio de questionários. A ingestão dietética foi avaliada por meio da aplicação do recordatórios 24 horas. O estado nutricional foi avaliado pelo índice de massa corporal (IMC), circunferência da cintura (CC) e razão cintura/altura (RCA) seguindo os pontos de corte para faixa etária estabelecida. A pressão arterial foi medida segundo o protocolo da Sociedade Brasileira de Hipertensão. Foram coletadas amostras de sangue a fim de analisar as concentrações séricas de 25-hidroxivitamina D (25(OH)D), Paratormônio (PTH), perfil glicolipídico, Proteína C Reativa (PCR), Alfa 1 Glicoproteína Ácida (AGP-A), Malondialdeído (MDA) e capacidade antioxidante total (CAT). A Pesquisa foi aprovada pelo Comitê de Ética em Pesquisa do CCS/UFPB sob o protocolo nº 0139/15. A Análise estatística foi realizada através do “Statistical Pac age for the Social Sciences” (SPSS Inc., Chicago, USA), versão 21, adotando-se significância de p<0,05. RESULTADOS: A insuficiência/deficiência de vitamina D (≤ 30 ng/mL) foi observada em 57,4 % (IC 95% -50,6-64) dos adolescentes, e em 76 % (IC 95%-62,8-86,3) dos classificados com excesso de peso. O consumo dietético de vitamina D foi inadequado (60 UI ± 18) em 100 % da amostra. Baixos níveis de 25(OH)D estiveram associados ao sexo feminino (RP= 2,3; IC 95 % = 1,8-3,5; p= 0,00), adiposidade central pelas medidas de CC (p=0,02) e RCA (0,01), menor nível de CAT (p= 0,01) e Cálcio sérico (p= 0,00). Os adolescentes apresentaram uma correlação inversa entre Colesterol total (p=0,01; r= -0,167) e IMC (p=0,02; r=-0,166) com os níveis de 25 (OH)D. Os valores de PCR, AGP-A, MDA estiveram aumentados no grupo com hipovitaminose D classificados com excesso de peso (p=0,00). CONCLUSÃO: A insuficiência/deficiência de vitamina D esteve associada ao IMC, CC e RCA, menor CAT e maiores níveis de colesterol total, sugerindo que níveis inadequados de vitamina D promove o aumento do risco no desenvolvimento de doenças associadas ao excesso de peso, processo inflamatório e estresse oxidativo

Avaliação da assistência pré-natal: relevância dos exames laboratoriais

Objective: To evaluate the prenatal care assistance provided to women assisted at delivery and examine the relevance of laboratory tests on the quality of prenatal care. Methods: A cross-sectional cohort study carried out in a university referral hospital, in the city of Santa Cruz-RN, from June to July 2014, including 50 pregnant women assisted at delivery. The women were between 18-40 years old and presented low obstetric risk. Data was collected from the prenatal medical chart and through a structured questionnaire. The characterization of the prenatal assistance adequacy was developed based on guidelines of the Prenatal and Puerperium Humanization Program (PPHP) and the Prenatal and Postpartum Technical Manual (PPTM). A descriptive analysis of the data was performed and the chi-square test was used for verification of differences between proportions. Results: It was observed that 86% (n=43) of the women initiated the prenatal care assistance early and had an average of 7.3 appointments. The clinical obstetric procedures had five or more records in 58% (n=29) of the sample. When assessed the laboratory tests records, a low percentage of adequacy was found in the 2nd recommended routine testing (32%, n=16). According to the parameters (PPHP and PPTM), prenatal care was suitable only in 24% (n=12) of the cases. When evaluated the classification of prenatal care assistance without the use of laboratory tests, the adequacy rose to 48% (n=24), presenting a statistically significant difference (pObjetivo: Evaluar la asistencia prenatal de mujeres asistidas en el parto y verificar la relevancia de las pruebas de laboratorio para la calidad del prenatal. Métodos: Estudio transversal desarrollado em un hospital universitario de referencia de la ciudad de Santa Cruz-RN en el período entre junio y julio de 2014 con 50 parturientas asistidas en el parto. Las mujeres tenían entre 18-40 años y riesgo obstétrico bajo. Fueron recogidos los datos de la tarjeta del prenatal y aplicación de un cuestionario estructurado. La caracterización de la adecuación del prenatal fue elaborada basado en las directrices del Programa de Humanización del Prenatal y Puerperio (PHPN) y em el Manual Técnico del Prenatal y Puerperio (MTPP). Se realizó um análisis descriptivo de los datos y el test Chi-cuadrado para verificar las diferencias de las proporciones. Resultados: Se observó que el 86% (n=43) iniciaron el prenatal precoz y tuvieron una media de 7,3 consultas. Los procedimientos clínicos de la obstetrícia tuvieron cinco o más registros en el 58% (n=29) de la muestra. En la evaluación del registro de las pruebas de laboratorio se observó un porcentual de adecuación bajo en la 2ª rutina de prueba establecida (32%, n=16). Según los parámetros (PHPN y MTPP), el prenatal fue adecuado solamente para el 24% (n=12) de los casos. En la evaluación de la clasificación de la asistencia del prenatal sin el uso de pruebas de laboratorio, la adecuación subió al 48% (n=24) con diferencia estadística significativa (pObjetivo: Avaliar a assistência pré-natal de mulheres assistidas ao parto e verificar a relevância dos exames laboratoriais na qualidade do pré-natal. Métodos: Estudo de corte transversal desenvolvido em um hospital universitário de referência na cidade de Santa Cruz- RN, no período de junho a julho de 2014, com 50 parturientes assistidas ao parto. As mulheres tinham entre 18-40 anos e possuíam baixo risco obstétrico. Os dados foram coletados a partir do cartão do pré-natal e aplicação de questionário estruturado. A caracterização da adequação do pré-natal foi elaborada com base nas diretrizes do Programa de Humanização do Pré-natal e Puerpério (PHPN) e no Manual Técnico de Pré-natal e Puerpério (MTPP).Realizou-se análise descritiva dos dados e o teste Qui-quadrado para a verificação de diferenças entre as proporções. Resultados: Observou-se que 86% (n=43) iniciaram o pré-natal precocemente e obtiveram uma média de 7,3 consultas. Os procedimentos clínicos obstétricos tiveram cinco ou mais registros em 58% (n=29) da amostra. Quando avaliado o registro de exames laboratoriais, observou-se um baixo percentual de adequação na 2ª rotina de exame preconizada (32%, n=16). De acordo com os parâmetros (PHPN e MTPP), o pré-natal esteve adequado apenas em 24% (n=12) dos casos. Quando avaliada a classificação da assistência do pré-natal sem o uso dos exames laboratoriais, a adequação subiu para 48% (n=24), com diferença estatisticamente significantes (

Association between hematological profile and serum 25-hydroxyvitamin D levels and FokI polymorphism in individuals with cystic fibrosis

<div><p>ABSTRACT Objective The present study aimed at investigating the association between hematological profile and serum 25-hydroxyvitamin D (25[OH]D) levels and Fokl polymorphism of the vitamin D receptor gene in individuals with Cystic Fibrosis. Methods A cross-sectional study that involved 18 men and women aged 0-25 years with Cystic Fibrosis. Socio-demographic information and the factors associated with sun exposure were obtained. Weight, height, and arm circumference were also measured. Blood sample was collected for the analysis of biochemical parameters (25[OH]D, parathyroid hormone, and calcium levels and blood count) and for the validation of the presence of FokI polymorphism in the vitamin D receptor gene. Results Among the participants, 33.33% (n=6) had vitamin D deficiency (19.60±6.180 ng/mL), and 27.8% (n=5) presented with anemia and low weight for age. In terms of genotype, 5.6% (n=1) presented with the FF genotype, 72.3% (n=13) had the Ff genotype, and 22.2% (n=4) had the ff genotype. Serum 25(OH)D levels were associated with hemoglobin (p=0.008) and hematocrit (p=0.019) levels and leukocyte count (p=0.0114). No association was observed between 25(OH)D levels and the genotypes (FF, Ff, and ff) (p=0.2451). In addition, an association was observed between FokI polymorphism and the total leukocyte count (p=0.01). Conclusion An association was observed between serum 25(OH)D levels and hemoglobin and hematocrit levels and leukocyte count in individuals with Cystic Fibrosis. Moreover, FokI polymorphism was associated with total leukocyte count.</p></div

Effect of vitamin D3 supplementation upon the metabolic and DNA methylation profile of cystic fibrosis patients

Background: Cystic fibrosis (CF) is a genetic disease that affects the transmembrane conductance regulator gene responsible for modulating chloride ion transportation in the cell membrane. Hypovitaminosis D is frequently observed among fibrocystic disease patients. Therefore, this study was aimed to evaluate the effect of vitamin D3 supplementation in patients with CF concerning their metabolic and deoxyribonucleic acid (DNA) methylation profiles. Methodology: A clinical trial involving 12 CF patients was carried out in Joao Pessoa. After assessment of hypovitaminosis D prevalence in the studied population, four patients with vitamin D3 insufficiency/deficiency were administered cholecalciferol megadose supplementation in addition to biochemical examinations and analysis of inflammatory and epigenetic indicators. The DNA methylation profile of the studied genes&apos; promoter regions was determined through a qualitative methylation restriction enzyme technique. Data were analyzed using the Statistical Package for the Social Sciences 25.0 software for T-tests, Mann-Whitney, and Wilcoxon test calculations. Results: Hypovitaminosis D was observed in 58%, 33% of the studied individuals. Patients with hypovitaminosis D reported blood sugar, glutamic-pyruvic transaminase (ALT), and uric acid levels significantly higher (p = 0.02; p = 0.05; p = 0.02, respectively) compared to individuals with sufficient 25-hydroxyvitamin D (25(OH)D), as well as elevated inflammatory values. Supplementation did not influence epigenetic nor metabolic parameters significantly, although the mean 25(OH)D serum concentration value increased from 18.3 ng/dl to 34.1 ng/dl (p = 0.06). Conclusion: Cholecalciferol megadose elevated 25(OH)D serum levels, although it did not alter inflammatory, glycemic, or epigenetic parameters. This encourages future studies on the matter since significant differences were found in blood sugar, uric acid, and ALT serum levels for the vitamin D3 insufficiency/deficiency group despite this studys small sample size. [JBCGenetics 2021; 4(2.000): 76-84